BACKGROUND AND AIM: Functional Capacity Evaluations (FCEs) are used to quantify physical aspects of work capacity. Safety is a critical issue for clinical use of an FCE. Patients with Chronic Low Back Pain (CLBP) are known to report a temporary increase in pain following an FCE, but it is not known whether this increase is a normal pain response to FCE. It is currently unknown how healthy subjects respond to an FCE and whether this should be interpreted as a normal reaction after physical exercise. This study was performed to quantify the intensity, duration, location and nature of the pain response following an FCE in healthy subjects and to compare this pain response with the pain response of patients with CLBP from a previous study.METHODS: A total of 197 healthy working subjects between 20 and 60 years of age volunteered to participate in this study. All subjects performed a 12-item FCE. Pain response was measured by a self-constructed Pain Response Questionnaire (PRQ). Descriptive statistics were used to describe the pain response following an FCE. Mann-Whitney and t-tests were performed to compare the data from this study with data of patients with CLBP from a previous study.RESULTS: About 82% of all subjects reported a pain response following the FCE. The intensity of the pain response after 24 h post FCE was a median of 3.0 on a numeric rating scale (0-10). About 78% of all pain was reducible to muscle soreness. Pain was most often reported in the upper legs (51%), the lower back (38%) the shoulders (37%) and upper arms (36%). Symptoms decreased to pre-FCE levels in a mean of 3 days. The pain response of 2 subjects (1%) lasted for 3 weeks. The intensity and duration of the pain response of healthy subjects was not significantly different from the response of patients with CLBP.CONCLUSION: Pain response of 99% of all subjects who reported a pain response was interpreted as normal. It was concluded that a pain response following an FCE can be expected in healthy subjects and that this pain response is a normal musculoskeletal reaction. The pain response of patients with CLBP resembles the pain response of healthy subjects.
Postprandial high glucose and insulin responses after starchy food consumption, associated with an increased risk of developing several metabolic diseases, could possibly be improved by altering food structure. We investigated the influence of a compact food structure; different wheat products with a similar composition were created using different processing conditions. The postprandial glucose kinetics and metabolic response to bread with a compact structure (flat bread, FB) was compared to bread with a porous structure (control bread, CB) in a randomized, crossover study with ten healthy male volunteers. Pasta (PA), with a very compact structure, was used as the control. The rate of appearance of exogenous glucose (RaE), endogenous glucose production, and glucose clearance rate (GCR) was calculated using stable isotopes. Furthermore, postprandial plasma concentrations of glucose, insulin, several intestinal hormones and bile acids were analyzed. The structure of FB was considerably more compact compared to CB, as confirmed by microscopy, XRT analysis (porosity) and density measurements. Consumption of FB resulted in lower peak glucose, insulin and glucose-dependent insulinotropic polypeptide (ns) responses and a slower initial RaE compared to CB. These variables were similar to the PA response, except for RaE which remained slower over a longer period after PA consumption. Interestingly, the GCR after FB was higher than expected based on the insulin response, indicating increased insulin sensitivity or insulin-independent glucose disposal. These results demonstrate that the structure of wheat bread can influence the postprandial metabolic response, with a more compact structure being more beneficial for health. Bread-making technology should be further explored to create healthier products.
Objective: Despite the common occurrence of lower levels of physical activity and physical fitness in youth with spina bifida (SB) who use a wheelchair, there are very few tests available to measure and assess these levels. The purpose of this study was to determine reliability and the physiologic response of the 6-minute push test (6MPT) in youth with SB who self-propel a wheelchair. Methods: In this reliability and observational study, a sample of 53 youth with SB (5-19 years old; mean age = 13 years 7 months; 32 boys and 21 girls) who used a wheelchair performed 2 exercise tests: the 6MPT and shuttle ride test. Heart rate, minute ventilation, respiratory exchange ratio, and oxygen consumption were measured using a calibrated mobile gas analysis system and a heart rate monitor. For reliability, intraclass correlation coefficients (ICCs), SE of measurement, smallest detectable change for total covered distance, minute work, and heart rate were calculated. Physiologic response during the 6MPT was expressed as percentage of maximal values achieved during the shuttle ride test. Results: The ICCs for total distance and minute work were excellent (0.95 and 0.97, respectively), and the ICC for heart rate was good (0.81). The physiologic response during the 6MPT was 85% to 89% of maximal values, except for minute ventilation (70.6%). Conclusions: For most youth with SB who use a wheelchair for mobility or sports participation, the 6MPT is a reliable, functional performance test on a vigorous level of exercise. Impact: This is the first study to investigate physiologic response during the 6MPT in youth (with SB) who are wheelchair using. Clinicians can use the 6MPT to evaluate functional performance and help design effective exercise programs for youth with SB who are wheelchair using. Keywords: 6-minute push test; adolescent; disabled children; spinal diseases; wheelchairs.
While the creation of an energy deficit (ED) is required for weight loss, it is well documented that actual weight loss is generally lower than what expected based on the initially imposed ED, a result of adaptive mechanisms that are oppose to initial ED to result in energy balance at a lower set-point. In addition to leading to plateauing weight loss, these adaptive responses have also been implicated in weight regain and weight cycling (add consequences). Adaptions occur both on the intake side, leading to a hyperphagic state in which food intake is favored (elevated levels of hunger, appetite, cravings etc.), as well as on the expenditure side, as adaptive thermogenesis reduces energy expenditure through compensatory reductions in resting metabolic rate (RMR), non-exercise activity expenditure (NEAT) and the thermic effect of food (TEF). Two strategies that have been utilized to improve weight loss outcomes include increasing dietary protein content and increasing energy flux during weight loss. Preliminary data from our group and others demonstrate that both approaches - especially when combined - have the capacity to reduce the hyperphagic response and attenuate reductions in energy expenditure, thereby minimizing the adaptive mechanisms implicated in plateauing weight loss, weight regain and weight cycling. Past research has largely focused on one specific component of energy balance (e.g. hunger or RMR) rather than assessing the impact of these strategies on all components of energy balance. Given that all components of energy balance are strongly connected with each other and therefore can potentially negate beneficial impacts on one specific component, the primary objective of this application is to use a comprehensive approach that integrates all components of energy balance to quantify the changes in response to a high protein and high energy flux, alone and in combination, during weight loss (Fig 1). Our central hypothesis is that a combination of high protein intake and high energy flux will be most effective at minimizing both metabolic and behavioral adaptations in several components of energy balance such that the hyperphagic state and adaptive thermogenesis are attenuated to lead to superior weight loss results and long-term weight maintenance.
Within TIND, Christian Roth studies the training of interactive narrative designers with the goal of developing teaching methods and learning tools for artists and designers to enable the creation of more effective artefacts. Interactive Narrative Design (IND) is a complex and challenging interdisciplinary field introducing new affordances in technique and user-experience. This requires practice-based research for further development of the educational format, demonstrating its potential while identifying and overcoming common learners’ challenges. This project aims to develop a framework for the design and evaluation of meaningful interactive narrative experiences that effectively stimulate a variety of cognitive and emotional responses such as reflection, insight, understanding, and potential behavior change. It provides tools, methods and activities to enable aspiring or practicing narrative designers through an interdisciplinary approach, including game design, immersive theatre, behavioral and cognitive psychology, and the learning sciences. HKU education means to prepare students for success in the creative industries and IND plays an important role for current and future jobs in education, arts and entertainment. IND has the potential to create an emotional impact and spark transformative change by offering agency, defined as the ability to influence narrative progression and outcomes in a meaningful way. This enables interactors to feel the weight of their own choices and their consequences, to explore different perspectives, and to more thoroughly understand complex multi-stakeholder issues, which could have significant impact on the success of emerging artistic, and learning applications. The research project is directly embedded in the curriculum of the HKU school Games & Interaction with annual educational offerings such as the Minor Interactive Narrative Design (MIND) and HKU wide broad seminars. Course evaluation and literature research will be used to create new and adjusted training for different HKU schools and the industry. Outcomes will be shared via an interactive website and events.
